Using Nolvadex (tamoxifen)

Nolvadex (tamoxifen) sometimes causes mild nausea and vomiting. However, Nolvadex (tamoxifen) may have to be taken for several weeks or months to be effective. Even if you begin to feel ill, do not stop using Nolvadex (tamoxifen) without first checking with your doctor. Ask your health care professional for ways to lessen these effects.

Swallow the Nolvadex (tamoxifen) tablets whole with a drink of water. You can take the Nolvadex (tamoxifen) tablets with or without food.

If you vomit shortly after taking a dose of Nolvadex (tamoxifen), check with your doctor. You will be told whether to take the dose again or to wait until the next scheduled dose.

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Dose of Nolvadex (tamoxifen)

Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Nolvadex (tamoxifen). If your dose is different, do not change it unless your doctor tells you to do so.

For oral dosage Nolvadex (tamoxifen) (tablets)

For breast cancer in women or men:
Adults—20 to 40 milligrams (mg) Nolvadex (tamoxifen) daily.

For reducing the risk of developing breast cancer in high-risk women:
Adults—20 milligrams (mg) Nolvadex (tamoxifen) a day, for five years

For reducing the risk of developing invasive breast cancer in women with ductal carcinoma in situ:
Adults—20 milligrams (mg) Nolvadex (tamoxifen) a day, for five years

If you miss a dose of Nolvadex (tamoxifen), do not take the missed dose at all and do not double the next one. Instead, go back to your regular dosing schedule and check with your doctor.

Storage of Nolvadex (tamoxifen)

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed.
• Be sure that any discarded medicine is out of the reach of children.

Side effects of Nolvadex (tamoxifen)

A woman should contact her healthcare profession right away if she develops:

• Changes in vaginal discharge
• Changes in vision
• Coughing up blood
• Leg swelling or tenderness
• Menstrual irregularities
• New breast lumps
• Pelvic pain or pressure
• Sudden chest pain
• Unexplained shortness of breath
• Vaginal bleeding

If you seek medical attention for any reason, be sure to tell your healthcare professional that you take Nolvadex (tamoxifen) or have taken Nolvadex (tamoxifen).

For women: Nolvadex (tamoxifen) may make you more fertile. It is best to use some type of birth control while you are taking it. However, do not use oral contraceptives (“the Pill”) since they may change the effects of tamoxifen. Tell your doctor right away if you think you have become pregnant while taking this medicine.

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Long term side effects of Nolvadex (tamoxifen):

• Nolvadex (tamoxifen) increases the chance of cancer of the uterus (womb) in some women taking it.
• Nolvadex (tamoxifen) may cause blockages to form in a vein, lung, or brain.
• In women, Nolvadex (tamoxifen) may cause cancer or other problems of the uterus (womb). Nolvadex (tamoxifen) also causes liver cancer in rats.
• In addition, Nolvadex (tamoxifen) has been reported to cause cataracts and other eye problems.

Discuss these possible effects with your doctor.

Check with your doctor as soon as possible if any of the following side effects occur:

For both females and males Less common or rare side effects of Nolvadex (tamoxifen)

Anxiety; blistering, peeling, or loosening of skin and mucous membranes; blurred vision; chest pain; confusion; cough; dizziness; fainting; fast heartbeat; lightheadedness; pain or swelling in legs; shortness of breath or trouble breathing; weakness or sleepiness; yellow eyes or skin

For females only Less common or rare side effects of Nolvadex (tamoxifen)

Change in vaginal discharge; chills ; fever; hoarseness; lower back or side pain; pain or feeling of pressure in pelvis; pain, redness, or swelling in your arm or leg; painful or difficult urination ; rapid shallow breathing; skin rash or itching over the entire body; sweating ; vaginal bleeding; wheezing

For females and males other reported side effects of Nolvadex (tamoxifen)

Bloating; constipation; darkened urine; diarrhea; difficult breathing; indigestion; itching; joint or muscle pain; large, hard skin blisters; large hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, and sex organs; loss of appetite; nausea; pain in stomach or side, possibly radiating to the back; red, irritated eyes; red skin lesions, often with a purple center; sore throat; sores, ulcers or white spots in mouth or on lips; unusual tiredness or weakness; vomiting

This medicine may also cause the following long term side effect that your doctor will watch for:

For both females and males

Less common or rare - Cataracts in the eyes or other eye problems; liver problems

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to Nolvadex (tamoxifen). Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For both females and males

Less common
Bone pain; headache; nausea and/or vomiting (mild); skin rash or dryness

For females only

More common
Absent, missed, or irregular periods; confusion; decrease in amount of urine; feeling of warmth redness of the face, neck, arms and occasionally, upper chest; lower back or side pain; menstrual changes; nausea; noisy, rattling breathing; painful or difficult urination; rapid, shallow breathing; skin changes; stopping of menstrual bleeding; swelling of fingers, hands, feet, or lower legs; troubled breathing at rest; vaginal bleeding; weight gain; weight loss; white or brownish vaginal discharge

Less common or rare
Abdominal cramps; black, tarry stools ; bleeding gums; blood in urine or stools; Bluish color changes in skin color ; discouragement; feeling sad or empty; irritability; itching in genital area; lack of appetite; loss of interest or pleasure; pain; pinpoint red spots on skin; stomach or pelvic discomfort, aching or heaviness; swelling ; trouble concentrating; trouble sleeping; unusual bleeding or bruising

For males only
Less common
decreased interest in sexual intercourse; inability to have or keep an erection; loss in sexual ability, desire, drive, or performance

This medicine may infrequently cause hair thinning or partial loss of hair.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Additional Information
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, tamoxifen is used in certain patients with the following medical conditions:

Malignant melanoma (a certain type of skin cancer)
Cancer of the endometrium (lining of the uterus)
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

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